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Home Care Week

Conditions of Participation:
Don't Get Caught Flat-Footed By New CoPs That Hit Next Month
Expect a learning curve as survey results come in. Home health agencies have been working... Read more
Surveys & Certification:
Survey Inconsistency Bedevils Agencies
Wide variation in how surveyors apply the new Home Health Conditions of Participation coul... Read more
Risk Management:
Beware These Trouble Spots When CoPs Take Effect
Is your Infection Control Plan from this decade? Home health agencies may feel overwhelme... Read more
Surveys & Certification:
Follow 9 Steps To Secure CoP Compliance Before It's Too Late
Tip: Have nurses start documenting time on verbal orders right now. Instead of relaxing a... Read more
Compliance:
Consider These Condition- Specific Tips From The Pros To Boost Your CoP Compliance
These notices must go to existing patients too. In addition to overarching activities you... Read more
Regulations:
Less May Be More When It Comes To Certain CoP Prep
Greater workload won't clinch increased CoP compliance. Home health agencies overwhelmed ... Read more
Industry Note:
Hospices Can Start Reporting Caps Dec. 31
Make sure your PS&R access is lined up. If you want to ring in the new year with a ta... Read more
Industry Note:
Correction For Payment System Glitch On Deck For January
Along with the new year will come a fix for a nagging payment glitch. The problem: The Me... Read more
Industry Note:
Review Your Hospice Quality Reporting Program Preview Reports Before They Disappear Along With The Old Year
Hospices have until almost New Year's Eve to review two new Hospice Quality Reporting Prog... Read more
Compliance:
OIG Pushes HH Surety Bonds In Latest Report To Congress
HHAs, hospice occupy basement in overpayment collections. Home care providers waiting for... Read more
Enforcement:
OIG Lists HHA Owners Who Have Headed To The Slammer
Owner on OIG's Most Wanted list caught. Ready to get hit with a fraud reputation once aga... Read more
Fraud & Abuse:
Whistleblower Case Against HHA Moves Forward
'Uncooperative and obstructive' behavior amps up fine levels. Kickbacks were a defining f... Read more
HIPAA:
Know When To Report A HIPAA Breach — And When Not To
Include this critical info with any breach report. Reporting a HIPAAbreach may be necessa... Read more
Industry Note:
Keep Your Eye On The Tax Bill
Will home care providers get coal in their stockings or presents under their trees? Signs... Read more
Industry Note:
Joint Replacement Bundling Rollback May Help Your Hospital Referral Situation
Medicare has finalized its August proposal to cut the Comprehensive Care for Joint Replace... Read more
Human Resources:
Stay Away From These Potentially Illegal Interview Questions
Some of these off-limits questions may surprise you. Whether you're new to interviewing p... Read more
Industry Note:
Proceed With RHC, SIA Adjustments, MAC Says
Did you let the window to submit a list of claims needing hospice payment reform billing c... Read more
Industry Note:
Learn From Hospice Quality Reporting Program FAQs
Check out the newest frequently asked questions received by the Hospice Quality Help Desk ... Read more
Industry Note:
LHC, Tenn. Health System Form Joint Venture
Lafayette, Louisiana-based LHC Group and Chattanooga, Tennessee-based Erlanger Health Syst... Read more
Industry Note:
Former Hospice Administrator Guilty Of Murder
It's not unusual these days to see home health agency and hospice executives in the fraud ... Read more
Industry Note:
Maxim To Pay $14.2 Million For Billing 'Error'
After Massachusetts announced last year that it was taking a number of fraud and abuse-fig... Read more
Survey & Certification:
Subunit Conversion Instructions Squeeze HHAs
Moratorium concerns persist. Home health agencies with subunits have less than two months... Read more
Compliance:
Follow These Steps To Convert Your Subunit
Changing to a freestanding agency is the default. There are two paths to changing your su... Read more
Regulations:
CoPs Stay On Track For Jan. 13, But HHAs Catch A CMP Break
Beware: Other alternative sanctions still can shut you down for noncompliance. Home healt... Read more
Human Resources:
Prioritize Update Of, Training On Sexual Harassment P&Ps
Quick response time to reports is key. Sexual harassment is more than just a national hea... Read more
Industry Note:
Home Care Features In OIG's Top Challenges
Surety bonds, improper payment rate catch watchdog agency's attention. Don't expect overs... Read more
Industry Note:
OIG Presses For Increased Physician Involvement In Hospice
Hospices gets their fair share of attention in the OIG's latest hit list, too. In addition... Read more
Industry Note:
Hospice Compare Glitch May Keep Patients From Finding You
Hospice Compare glitches continue. "The location search on Hospice Compare may return inco... Read more
Industry Note:
You're Responsible For These 2 New Therapy Codes Under Home Health Bundling
Two new codes are replacing two old codes on the consolidated billing list for home health... Read more
Industry Note:
Incorrect Claims Rejections For HHAs Reappear
Incorrect RAP and claim rejections for reason codes U6815, U6816, U6817, and U6818 are onc... Read more
Industry Note:
Heed Vital Tip About Targeted Probe & Educate From This HHH MAC
Don't miss this crucial detail when it comes to Targeted Probe & Educate review. "It ... Read more
Industry Note:
Patient Safety Goals Ride Another Year
Take a look at The Joint Commission's five National Patient Safety Goals for home care pro... Read more
Prospective Payment System:
2018 Final Rule Ramps Up HH QRP Burden, Despite Dropped OASIS Items
Section GG to expand. Get ready to put some serious resources into OASIS education and tr... Read more
Quality:
Say Hello To 7 New Quality Measures In Next Few Years
Protests against falls measure fell short. While pressing concerns ranging from new Condi... Read more
Quality:
Brace For New Quality Measures To Come In These Areas
Cognitive function measures are on the horizon. Home health agencies may have gotten a re... Read more
Regulations:
Find OASIS, HH QRP Changes Here
Use this handy change table Medicare provides. Confused about which OASIS and HH QRP requ... Read more
OASIS:
2018 Is The Last Year You Must Collect These OASIS Data Items
Data Items Caution: Some items will be only partially gone. The Centers for Medicare &am... Read more
Survey & Certification:
Be Ready To Jump On Subunit Conversion Instructions
Converted subunit surveys to get bumped up. Home health agencies hoping Medicare would gi... Read more
Compliance:
Are You Covering These 6 HR Bases?
Tip: 50 or more employees means FMLA applies to you. You may have a very robust program i... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade's worth of information on a multitude of home health topics at... Read more
Mergers & Acquisitions:
LHC, Almost Family Merge
Market consolidation on a large scale announced. Two of the original "Big Four" publicly ... Read more
Industry Note:
Wait A Bit Longer For Hospice Compare Update
New data refresh bumped to next month. Hospices aren't the only ones having adjustment di... Read more
Industry Note:
Pharma Exec New HHS Secretary Nominee
Following Tom Price's resignation as Department of Health & Human Services Secretary, ... Read more
Industry Note:
Heed New Therapy Cap
For home health agencies that furnish outpatient Part B therapy in the home, therapy caps ... Read more
Industry Note:
Diabetes Program Expands
Your patients might benefit from a provision in the Medicare Physician Fee Schedule Final ... Read more
Industry Note:
11-State Chain Makes Buy
The Ensign Group's home health and hospice subsidiary, Cornerstone Healthcare Inc., has ac... Read more
Industry Note:
Agency Faces $4.5M Repay
Personal Touch Home Care of Ohio owes the state $4.5 million in Medicaid overpayments, Ohi... Read more
Industry Note:
Prep For Electronic NOEs
The Jan. 2 start date for submitting Notices of Election electronically is getting closer,... Read more
Prospective Payment System:
Check Your Wage Index, Case Mix To See How 0.4% Cut Will Impact Your Bottom Line
Plus: You may not have to give up hope for the rural add-on quite yet. While the news tha... Read more
Reimbursement:
Crystal Ball Shows HHGM In Home Care's Future
Therapy is likely on its way out as a payment factor, regardless of HHGM's fate. A united... Read more
Regulations:
Final Rule Contains HHQRP, VBP Changes
Gear up for new quality measures in 2020. In addition to the payment-related provisions, ... Read more
Medical Review:
MAC Reveals Threshold For TPE Inclusion
F2F errors dominate Home Health Probe & Educate results. Since Medicare officials fir... Read more
HIPAA:
Learn HIPAA Lessons From These Real-Life Breaches
Warning: Phishing is a very real threat. With the 2018 HH PPS final rule just out, the dr... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade's worth of information on a multitude of home health topics at... Read more
Industry Note:
Use This Workaround For OASIS Matching Edit Glitch
Get up to speed on deleting and restoring Revenue Code lines. It may be good news that yo... Read more
Industry Note:
CMS Unveils New Appeals Option
If you're not a Medicare appeals frequent flier, you now have an option that may expedite ... Read more
Industry Note:
Don't Let Home Care & Hospice Month Pass You By
It's not too late to celebrate Home Care & Hospice Month this month, or Home Care Aide... Read more
Industry Note:
HEART Pilot Proceeds
In its final rule for 2018 hospice payment, the Centers for Medicare & Medicaid Servic... Read more
Industry Note:
Compare Deadline Looms
Hospice Compare's next data refresh will be in February, but the deadline for the data sup... Read more
Industry Note:
Hospice Billing Confuses
Not sure what to do about your credit balance reporting duties if you didn't submit Routin... Read more
Prospective Payment System:
CMS Puts HHGM On Ice In 2018 Final Rule
Access issues loom if pay reform isn't budget neutral, expert warns. The home health indu... Read more
Reimbursement:
2018 PPS Final Rule Keeps 0.4 Percent Pay Cut
Bad news: Rural add-on is not renewed. Medicare's drastic payment revamp may be off the t... Read more
Conditions of Participation:
Draft CoP Guidelines Fall Short Of Expectations
Some HHAs hoping for a Halloween treat feel tricked instead. If you were thinking you mig... Read more
Regulations:
HHAs Welcome Draft CoP IG Clarification On Verbal Orders And POCs
Other guidance is not as well received. The draft Interpretive Guidelines for the impendi... Read more
Hospice:
Largest Hospice Fraud Settlement Ever Should Put Providers On Guard
Compensation, marketing practices cost VITAS. You'd better take a hard look at the financ... Read more
Compliance:
Take These 4 Steps To Guard Against Fraud Charges
What's the status of your compliance plan? Following VITAS' record-breaking fraud settlem... Read more
Industry News:
Last Defendant In Jacques Roy Case Sentenced
Agency co-owner gets 10 years. The massive fraud scheme masterminded by Dr. Jacques Roy, ... Read more
Industry News:
Stay On The Right Side Of Patient PHI Requests
Need some help making sure you're complying with HIPAA when patients request their PHI? Th... Read more
Industry News:
Sidestep This Common Election Statement Landmine
You'd better be sure how to document a change in your hospice patient's attending physicia... Read more
Industry News:
Study Up On OASIS 1-Clinician Rule That Hits Jan. 1
Still not clear on CMS's expansion of the one-clinician rule for OASIS data collection? Yo... Read more
Industry News:
Consult New OCR Guidance On HIPAA Privacy
Patient privacy and security remain challenges for healthcare providers and their staffs w... Read more
Industry News:
Avail Yourself Of New HHQRP Quick Reference Guide
Don't let Home Health Quality Reporting Program requirements trip up your compliance statu... Read more
Reimbursement:
Next Year's Cut Matters Too
Don't overlook another blow to your pay. Home health agencies have high hopes that the Ho... Read more
Prospective Payment System:
HHGM Admission Source Factor Poised To Create Problems
Accuracy will place heavy burden on agencies. One step in the HHGM case mix process is go... Read more
Billing:
HHGM Sets Up HHAs For Billing Errors
Determining patients' admission sources accurately is going to pose problems, commenters o... Read more
Prospective Payment System:
Non-Medicare Stays Would Influence Your Medicare Pay
You may be on the hook for hospitals' billing problems under HHGM. If you think determini... Read more
Hospice:
MAC Denies Nearly Half Of Hospice Claims In Recent Probe
Targeted Probe & Educate makes understanding these denial reasons critical. Medicare ... Read more
Medical Review:
Follow These 3 Steps To Head Off Common Hospice Denials
Outdated forms put you at risk. With so much on your plate these days, you may be letting... Read more
Compliance:
Does Your Election Statement Include Everything It Needs?
Tip: Check the attending info. If your hospice election statement fails to include every ... Read more
Medical Review:
Review TPE Basics
You have 3 chances to get it right. If you've ignored Targeted Probe & Educate detail... Read more
Industry Note:
MACs Take On Physician Home Health Education
Contractors to review physician requirements. You can encourage your referring physicians... Read more
Industry Note:
Bogus Home Health Referrals Feature In Latest Fraud Case From Detroit
A Detroit-area physician has pled guilty to a conspiracy charge in a wide-ranging Medicare... Read more
Prospective Payment System:
Proposed HHGM Changes Stir Up Therapists
CMS expects agencies providing more therapy visits to see bigger pay cuts under pay reform... Read more
Payment:
HHGM Bell Tolls For Therapy-Intensive HHAs
It’s not just your imagination — Medicare is out to cut therapy reimbursement ... Read more
Therapy:
The Gaming Will Go On
Eliminating therapy from case mix won’t fix what ails it, commenters say. The Cente... Read more
Reimbursement:
$1 Billion Payment Cut Will Not Improve Home Health Care
Get your act together on case mix, commenters tell CMS. To eliminate therapy as a HH PPS ... Read more
PPS:
Payment Reform Must Be Budget-Neutral
One of the most important tenets of a viable payment reform model is that it be budget-neu... Read more
OASIS:
OASIS Edit Will Return — Not Deny — Claims, For Now
Take 3 steps to resolve 37253 problems. The OASIS edit that took effect in April is killi... Read more
Industry Note:
CMS Slows Implementation Of Cross-Setting Measures
These IMPACT Act elements shouldn’t impact you in 2018. You’ll have one less ... Read more
Industry Note:
HHGM Bill Disappoints
A new bill to delay the Home Health Groupings Model may not be all home health agencies we... Read more
Industry Note:
Toe The Sequential Billing Line, MAC Warns
Failing to follow sequential billing rules for hospice is not only cash flow-draining, it&... Read more
Industry Note:
Mass. Agency Owner Arrested For Fraud
The owner of Worcester, Massachusettsbased Lifestream Healthcare Alliance has been arreste... Read more
Industry Note:
Don't Include Patient Names On Hospice Adjustment List
If you want to take advantage of easier hospice billing corrections for Routine Home Care ... Read more
Industry Note:
Hospital Closes Agency
Another hospital-based home health agency has closed. Wallowa Memorial Hospital in Enterpr... Read more
Industry Note:
Hurricane Scams A Threat
Con artists always know to strike when the irons are hot. And in the midst of the Hurrican... Read more
Prospective Payment System:
Home Health Commenters Blast HHGM Model
PPS rule comments go from 89 last year to 1,350 this year. If CMS was testing the waters ... Read more
Reimbursement:
Commenters Take Aim At Shorter Billing Period
Expect SNF, hospital usage to go up, commenters warn CMS. Many commenters on the Home Hea... Read more
Diagnosis Coding:
Case Mix Steps Based On Coding Need Major Fix
Six clinical groups won’t accurately reflect resource need, commenter argues. Diagn... Read more
Policy:
Industry Continues To Wage War Against HHGM
Take to Twitter to vent your spleen. Home health agencies are stepping up their efforts t... Read more
Medical Review:
MACs Drop A Few More Hints About TPE Targets
Plus: Don’t hit this key in DDE, MAC warns. If you haven’t received a letter ... Read more
Industry Note:
Long LOS Hospice Claims To See Probe & Educate Review
Comparative Billing Reports coming out. Exactly which home health agencies and claims wil... Read more
Industry Note:
Learn How To Use Condition Code 21
Don’t let billing confusion about no-pay claims lead to cash flow problems. The pro... Read more
Industry Note:
Lawmakers Propose OT Changes In Home Care
Home health agencies have a lot on their minds with the HHGM proposal looming, but longer-... Read more
Industry Note:
FL Acquisitions Lead To $40M Overpayment Demand For This For-Profit Chain
Statistical sampling and extrapolation have led to a $38.8 million overpayment request for... Read more
Industry Note:
Ohio Agency Faces $4 Million Medicaid Overpayment
Statistical sampling and extrapolation aren’t just Medicare audit problems. Healing... Read more
Industry Note:
Public Health Agency To Close
Home Care of Central Illinois, a division of the Logan County Department of Public Health,... Read more
Industry Note:
Former San Diego Hospice Building Sold To Developers
San Diego-based Scripps Health, the health system that bought high-profile San Diego Hospi... Read more
Industry Note:
PA Agencies Plan Merger
The parents of the Visiting Nurse Association of Erie County and Regional Home Health and ... Read more
Medical Review:
Respond To ADRs — Or Else, CMS Warns
Targeted Probe & Educate is about to make ADR responses critical to your survival. No... Read more
Billing:
How To Check For An ADR
Tip: Check FISS Page 07 for the due date. If you have been relying on paper letters for y... Read more
Reimbursement:
Fight Off Non-Response Denials With These 9 Pointers
A must: Track your response times. Are you in the mood to get put on indefinite medical r... Read more
Documentation:
Consult These ADR Documentation Tools
Compare your responses to these checklists. Responding to your ADRs will go a long way to... Read more
Hospice:
Submit Your Hospice Billing Corrections — Or Maybe Not
Critical questions remain unanswered. CMS has released instructions that will streamline ... Read more
Reimbursement:
Adjust Incorrect Hospice Pay With These Instructions
Tip: Don’t include transfer patients on your list. Hospices’ wait is over for... Read more
Industry Note:
Watch For Your TPE Letter
Halloween isn’t the only scary thing happening in October. The weather might have b... Read more
Industry Note:
OASIS Waiver Granted In Puerto Rico, USVI
In a tragic scenario that has become all too familiar in recent weeks, HHS Secretary Tom P... Read more
Industry Note:
Hundreds Of Home Care Providers Risk Billing Status
Hundreds of Fiscal Intermediary Standard System Direct Data Entry users were poised to hav... Read more
Industry Note:
Submit Your Medicare Reform Ideas By Nov. 20
The change in presidential administrations may give you a chance to offer big-picture sugg... Read more
Industry Note:
Ohio Couple Receives Prison Sentences For HH Fraud
A couple who owned Columbus Home Health Care Services in Ohio has been sentenced to prison... Read more
Industry Note:
Texas Post-Acute Chain Plans Growth
Plano, Texas-based LifeCare Home Health has acquired Texas chain Beyond Faith Homecare &am... Read more
Industry Note:
Medicare Releases New CCM Videos
Check out new Chronic Care Management resources, including 30-second animated videos expla... Read more
Prospective Payment System:
Home Care Industry Declares War On HHGM Model
Give CMS your two cents by Sept. 25. Medicare’s proposal to reform the Home Health ... Read more
Fraud & Abuse:
Another Stiff Sentence Handed Down For Home Care Fraudster
Plus: Shocking 75-year sentence being appealed in Houston fraud case. It may not be the 7... Read more
Reimbursement:
Beware RAP Billing Pitfalls
MAC offers pre-billing tool to avoid returned claims. If you’re not careful, some m... Read more
Referrals:
Share Hints For CCM Coding With Your Referral Sources
Physicians who refer to you can obtain their rightful reimbursement for your patients. Ch... Read more
Referrals:
5 CCM Coding Pointers Your Referral Sources Must Know
Tip: The care plan matters. So how can your referral sources accurately report CPT® c... Read more
Industry Note:
Prepare Your NOE Agreements Before New Year's, MAC Urges
NOE companion guide is out. Your ability to eliminate — or at least drastically red... Read more
Industry Note:
Watch Out For These Claims System Glitches
If billing system problems have been slowing your cash flow, you’re not alone. Glit... Read more
Industry Note:
Use New Medical Review Tool To Ward Off TPE Failure
Medical review is on the rise, including the potentially devastating Targeted Probe & ... Read more
Industry Note:
Get New QoPC Star Rating Methodology Info Here
Changes are ahead for your Home Health Compare Quality of Patient Care star rating, includ... Read more
Industry Note:
Be Alert To Hospice Compare Preview Report Error
If your Hospice Compare preview report for the next refresh looks a little weird, it ... Read more
Industry Note:
Transition Period To Ease New Medicare Card Debut
Medicare won’t start sending out its new beneficiary cards until next April, bu... Read more
Industry Note:
Health Systems, HHAs Partner Across The Country
Three recent deals highlight the popularity of health systems joining forces with hom... Read more
Industry Note:
New Orleans HH Patient Recruiter Convicted
A patient recruiter has been convicted of Medicare fraud in a scam centering around mental... Read more
Reimbursement:
Physician Length Estimate Denials Plague HHA Claims
Avoid a last-minute scramble to comply. Like face-to-face, another confusing requirement ... Read more
Medical Review:
Prevent Physician Length Estimate Denials With 8 Pointers
Have you adjusted your billing audit process for this requirement? Two years have gone by... Read more
Compliance:
Docs Must Get Specific With Their Length Estimate Statements
Learn from these MAC examples. Vague wording is not going to cut it for the two-year-old ... Read more
HIPAA:
Head Off Potential HIPAA Breaches With These Surefire Strategies
Don’t get slack about cyberattacks. Sometimes HIPAA breaches are unavoidable &mdash... Read more
Emergency Preparedness:
OASIS Waiver Granted In Irma-Affected Areas
Home care providers scramble to implement emergency plans. Florida has one of the nation&... Read more
Industry Note:
Technical Oversight Will Cut Off Your Billing
NOE filing is at risk, MAC warns. Nearly half of home health and hospice FISS DDE users h... Read more
Industry Note:
Medicare Termination Notices Go Online
The Centers for Medicare & Medicaid Services has started publishing termination notice... Read more
Industry Note:
Access Your Compare Preview Report Before Next Refresh
Hospices have until Sept. 28 to get a sneak peek at their next Hospice Compare stats. Comp... Read more
Industry Note:
Get Free IMPACT Act Care Coordination Info
Dial in for free information on care coordination under the IMPACTAct from Medicare. The C... Read more
Industry Note:
Stark Law Violations Lead To $1.8M Settlement
Six Tennessee home health agencies have agreed to pay $1.8 million to settle False Claims ... Read more
Industry Note:
Industry's Live Discharge Rate Is Low, Expert Argues
The link between hospices’ live discharge rates and their profitability continues to... Read more
Industry Note:
Chain, Catholic Health System Form Joint Venture
LHC Group and Irving, Texas-based CHRISTUS Health will form a joint venture covering 21 CH... Read more
OASIS:
Documentation Requirements Pared Back For OASIS Matching Edit Appeals
You can’t skip checking the final validation report. If you missed a change related... Read more
Enrollment:
Texas Moratoria Lifted After Harvey ® But Not For HHAs
Medicare has shot down 18 waiver requests. What will the future hold for the home health ... Read more
Regulations:
CMS Grants Exception Without Waiver For VBP Requirements In Harvey Areas
Plus: Waiver in effect for Irma, with more expected. Medicare continues to work on Harvey... Read more
Quality:
Weekends Don't Exempt You From Medication Deadline
Not every drug review problem qualifies for this item — and the next-day deadline. ... Read more
Hospice:
Hospice Compare Ramp-Up Rocky For Some
Plus: Compare address update won’t show up right away If seeing your name splashed ... Read more
Industry Note:
MA Plans Must Cover Maintenance Services, Too
A new Medicare website about the Jimmo settlement may lend some backup to your maintenance... Read more
Industry Note:
Sit Tight While MACs Work Out Hospice Billing Fix
Get ready for the hospice payment reform payment error saga to continue a little while lon... Read more
Industry Note:
Shared Corporate Parent Potential Conflict Of Interest
Patient steering is back on the radar, thanks to a new study about corporate investors in ... Read more
Industry Note:
ICD-10 Mapping Tool Available For Last Time
The effective date for ICD-10 2018 code updates is fast approaching on Oct. 1, and for the... Read more
Industry Note:
NPIs Required Soon
If you’ve lagged behind on using NPIs for when checking patients’ Medicare sta... Read more
Industry Note:
Heed Cap Reporting Tips
Avoid a payment disruption by taking a few extra steps with your hospice cap reporting, on... Read more
Industry Note:
HH Buyer Backs Out
Island Hospital in Anacortes, Washington has sold its Island Hospital Home Health unit to ... Read more
Medical Review:
Probe & Educate Review Campaign Revs Up
‘Targeted’ P&E will review up to 40 claims per agency, per round. If you ... Read more
Reimbursement:
Follow These Crucial Steps For TPE Risk Management
Billing staff aren’t the only ones who should be involved in ADRs. How you respond ... Read more
Emergency Preparedness:
CMS Grants Blanket OASIS Waiver For Harvey-Area HHAs
Make sure you’re up to date when Medicare’s EP requirements hit in November. ... Read more
Compliance:
Consult These Emergency Preparedness Resources
Home care providers affected by Hurricane Harvey can refer to these resources to see what ... Read more
Fraud & Abuse:
Another Lengthy Sentence Handed Down For HH Fraud
HHA owner draws 40 years. Potential fraudsters may now think twice about choosing the hom... Read more
Industry Note:
Medicare Pulls Back On Damaging Bundling Models
CJR already squeezing home health. Many home health agencies breathed a sigh of relief wh... Read more
Industry Note:
Mississippi Physician Sentenced To 3 Years In Prison For Bogus Hospice Referrals, Kickbacks
A Mississippi physician convicted in a hospice fraud scheme has received a prison sentence... Read more
Industry Note:
Whistleblower Lawsuit Costs Louisiana Home Health Agency
Baton Rouge, Louisiana-based Charter Home Health has agreed to pay $1.7 million to settle ... Read more
Industry Note:
Texas DADS Under Fire For Loose Regulation Of HHAs
Home health agencies often feel like they get an unnecessary hassle from state and federal... Read more
Industry Note:
Medicare Suspension Held Off While HHA Argues Survey By Fired Employee Was Flawed
How do you think your agency would fare if your surveyor was an aggrieved former employee ... Read more
Prospective Payment System:
30-Day Period Billing Proposal Throws Agencies For A Loop
Each shortened period must meet LUPA threshold, CMS clarifies. In CMS’s latest Home... Read more
Regulations:
CMS Punts On Budget Neutral Question For HHGM
Plus: Next Compare refresh may not look so fresh. The number-one question on many home he... Read more
Hospice:
Check QIES To See Whether 2% Cut Will Hit You Oct. 1
CAHPS, HEART also addressed in forum. If you didn’t receive a letter saying you&rsq... Read more
Compliance:
Beef Up Your Compliance Efforts In Light Of 75-Year Sentence
Unprecedented jail term for home health fraud handed down. If you’ve been giving yo... Read more
Compliance:
Don't Get Lulled Into Non-Compliance
Real-time data mining may nab more subtle errors. The spectacular scope of two fraud case... Read more
Survey & Certification:
No HHA Has Scored Moratoria Exception Yet
CMS should nix statewide bans, rep says. Although the Office of Management and Budget has... Read more
Quality:
Hospice Compare Now Live
Hospices score lower on one measure. Potential patients, referral sources, and competitor... Read more
Quality:
Ready Or Not, You're Publicly Judged On These 7 Measures
Plus: Expect 8 more CAHPS measures to go live soon. Unless you don’t meet the data ... Read more
Industry News:
OIG Adds Hospice Investigation To Its Work Plan
Focus on medication reimbursement continues. A new Work Plan topic for the HHS Office of ... Read more
Industry News:
Dial In For Free Info On New Spending Quality Measure
Find out more about the new IMPACT Act-required quality measure, Medicare Spending Per Ben... Read more
Industry News:
Proposal To Publish Accreditors' Survey Details Nixed
If you’re accredited by a third-party organization like JCAHO or CHAP, you don&rsquo... Read more
Industry News:
Texas Physician Convicted Of Home Health Fraud
A federal jury convicted Houston physician Ronald Kahn in a $1.5 million Medicare fraud sc... Read more
Industry News:
Ohio Nurse Convicted Of Fraud In Patient Death Case
An Ohio home care nurse who has already been sentenced by the state to serve 10 years for ... Read more
Prospective Payment System:
Use This Free Tool To See How HHGM Hits Your Bottom Line
How much of the $1 billion cut would be yours? If you ran claims through Medicare’s... Read more
Value-Based Purchasing:
VBP Results Preview Slated For This Month
Clock will start ticking on 30-day recalculation requests. CMS may not have announced the... Read more
Hospice:
Hospice Final Rule's Physician Discussion May Mean Tighter Medical Review
Hospice admission assessment can’t be basis for eligibility, rule says. A deluge of... Read more
Quality:
HEART Likely First Step To Hospice Case Mix System, VBP
Brace for serious payment changes ahead. Switching from the current Hospice Item Set tool... Read more
Hospice:
CMS Will Take Its Time With HEART, It Promises
It’s your turn to tell CMS what to do. How will Medicare make sure that it minimize... Read more
Industry Note:
Statewide HHA Moratoria Persist
Covering whole states inhibits fraudsters’ endruns around the ban, CMS contends. Th... Read more
Industry Note:
New OASIS-C2 Manual Effective Jan. 1 Contains Important Clarification You Shouldn't Miss
Take a look at the new version of the OASIS-C2 Guidance Manual, which is effective Jan. 1.... Read more
Industry Note:
New Home Health Agency Claims Edits Based On G-Codes On Deck
Home health agencies have more claims edits to look forward to. In addition to Value-Based... Read more
Industry Note:
Put CMS's Free Educational Event About Drug Regimen Review On Your Calendar
You can dial in Aug. 17 for a free CMS call regarding medication review home health requir... Read more
Prospective Payment System:
Home Health Payment Reform Would Cut Nearly $1 Billion From Medicare Spending
Everybody loses under massive reduction. If four years of rebasing cuts and repeated case... Read more
Reimbursement:
PPS Overhaul Eliminates Therapy, Cuts Episodes To 30 Days
Source of admission occurrence code will carry risks. If you didn’t pay attention w... Read more
Billing:
HHGM Would Double Billing, Collections Workload
Will you say good-bye to RAPs — and upfront payments? A switch to a 30-day episode ... Read more
Prospective Payment System:
Another Home Health Payment Rule, Another Pay Cut
CMS calls for 0.4% reduction to home health payments next year. While the drastic HH PPS ... Read more
Value-Based Purchasing:
VBP Changes On Deck
Bid farewell to this VBP measure concerning drug education. The Value-Based Purchasing de... Read more
OASIS:
CMS Plans To Cut, Modify 35 OASIS Items Under HHGM
Prepare for ‘huge changes’ to OASIS. Payment rates aren’t the only thin... Read more
Hospice:
Medicare Sticks With Reduced Rate Of Increase For Hospice In 2018
Hospice rates will rise 1% on average. If you’ve been making plans for next fiscal ... Read more
HIPAA:
Don't Risk Fines By Overlooking HIPAA BA Agreements
Warning: Your agency's small size won't save you from HIPAA penalties. If your me... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade’s worth of information on a multitude of home health top... Read more
Industry Note:
NOEs To Finally Go Electronic
Stay tuned for ‘companion guide’ for NOE transmissions. Hospices’ billi... Read more
Industry Note:
Industry Remembers Home Care Icon
Home care icon and National Association for Home Care & Hospice President Val Halamand... Read more
Conditions of Participation:
Prioritize These 6 Challenges In Your CoP Prep
Will your vendors be as ready as you are? While home health agencies are happy that the f... Read more
Regulations:
Beware States Lagging On CoPs
States are dragging their feet on subunits, state licensure changes. You’ve been wo... Read more
Fraud & Abuse:
OIG On The Hunt For Fraud Indicators In Your Data
Your own data may single you out for scrutiny. This month shows why you should be keeping... Read more
Enforcement:
Home Health, Hospice Fraud Remains Front & Center
Fraud takedown highlights Medicare fraud. Convincing lawmakers you need a break might be ... Read more
Industry Note:
Live Discharge Rate Linked To Profitability, Study Finds
What does your live discharge rate suggest about your hospice? A new study adds fuel to t... Read more
Industry Note:
MAC Denies 9% Of High-Resource Claims In One Review
Therapy once again tops the reasons for denials in Palmetto GBA’s latest medical rev... Read more
Industry Note:
OIG Educates Providers On How To Report Fraud — Anonymously
Whistleblower lawsuits are costing home care providers big. But disgruntled employees don&... Read more
Industry Note:
Know When To Include Another NPI On Claims
You’ll need to know the NPIs of the facilities in which your patients reside when re... Read more
Industry Note:
HH Nearly Only Sector With Spending Decrease
While policy- and lawmakers seem to be furiously throwing up roadblocks to home health gro... Read more
Industry Note:
Keep Tabs On Your Revalidation Deadline
You may want to check CMS’s revalidation schedule to see if your date is coming... Read more
Industry Note:
New PEPPER Data Out
Get your latest free benchmarking stats from Medicare. A new release of the Home Health Ag... Read more
Industry Note:
HealthSouth Changes Name
HealthSouth Corp. will change its name to Encompass Health Corp., effective in January, th... Read more
Industry Note:
Free HIPPA BA Tool
If one of your business associates commits a HIPPA breach with your patients’ data, ... Read more
Industry Note:
Medicaid HH Funding Still In Peril
The Senate’s version of an Obamacare repeal-and-replace bill has failed to pass the ... Read more
Conditions of Participation:
HHAs Must Wait For CoP Guidelines Until December
CMS confirms six-month Conditions of Participation delay in final rule. Ramping up to com... Read more
Compliance:
Don't Wait For Interpretive Guidelines To Prepare For New CoPs
Use the final rule for compliance clues. You may be frustrated that you have to wait unti... Read more
Quality:
QAPI Delay Gives Agencies Breathing Room
Get started identifying your projects ASAP. Along with the six-month delay for Conditions... Read more
Lawsuits:
Whistleblowers Win Big With Lawsuits Against Hospice Chain
Debility diagnoses, medical director relationships in the fraud spotlight. Two more remin... Read more
Human Resources:
Use A Code Of Conduct To Improve Your Workplace
Minimize discipline issues by employing group consensus. If you feel like your company&rs... Read more
Industry Note:
Another Study Proves Home Care Saves Money
Post-SNF home care visit within a week makes a big difference. A new study shows home car... Read more
Industry Note:
Resubmit These Claims Rejected In Error For HICNs
A claims processing glitch at one HHH Medicare Administrative Contractor may mean more wor... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade’s worth of information on a multitude of home health top... Read more
Industry Note:
Access Enrollment Status Check
Not sure of your enrollment application status? You can check online with HHH Medicar... Read more
Industry Note:
Take This MAC Survey On Hospice Physicians
Want to give Medicare your two cents about the physician’s role in hospice care? Now... Read more
Industry Note:
HHA Owner, Employee Face Medicaid Fraud Charges
Harmony Home Health Care owner Elena Kurbatzky and employee Natan Zalyapin have been arres... Read more
Industry Note:
Hospice Owner Convict Settles FCA Charges Too
Four hospice executives in a high-profile Pittsburgh fraud case have agreed to pay more th... Read more
Industry Note:
CMS Makes PECOS Enrollment Easier On Docs
Making sure your referring physicians are in the PECOS database may become easier, now tha... Read more
Prospective Payment System:
PAC PPS Should Lower Therapy Patient Pay, MedPAC Says
Copays should be a component of the unified payment system, report suggests. As home heal... Read more
Know Your Facts:
PAC PPS Would Raise Payment Levels For More Than Half Of HHAs
Ortho patients would take biggest hit under new payment system, MedPAC forecasts. Check o... Read more
Hospice:
Transition Year Cap Clarification Helps Hospices
Don’t forget your cap report will come a month earlier. It’s not often that h... Read more
Human Resources:
Make Your Meetings More Effective With This Advice
Are you moderating fiercely? If you feel like your agency meetings are time-consuming wit... Read more
Industry Note:
Keep Watch On Senate Health Care Bill
Medicaid funding changes would impact home care most. The future of your Medicaid busines... Read more
Industry Note:
Understand What Happens When Your OASIS Doesn't Match Your HIPPS Code
With the OASIS matching edit now in place and denying claims that lack a supporting OASIS,... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade’s worth of information on a multitude of home health top... Read more
Industry Note:
Seniors Continue To Patrol For Medicare Fraud
Don’t be surprised if you get some pointed billing questions from your patients. The... Read more
Industry Note:
Here's How To Handle MA Plans On HIS
If A1400, the Hospice Item Set question on payors, is giving you fits, the Centers for Med... Read more
Industry Note:
Beware Using Non-Compliant ABN Form
Don’t forget to switch out your ABN form. The new version of the form took effect Ju... Read more
Industry Note:
One State Reaches 100% PEPPER Downloads
Are you falling farther behind your peers by failing to download your free PEPPER benchmar... Read more
Industry Note:
Prevent Wayward Appeal Letters With This Check
Be sure your address in the Fiscal Intermediary Shared System (FISS) and the Natio... Read more
Industry Note:
SSN-Free Card Change Affects Home Care A Little Differently
Home health agencies will get a little extra time to use the old HICNs when Medicare chang... Read more
OASIS:
OASIS Matching Edit Hits Claims Hard
Agencies angered by unexpected denials. Anew Medicare claims edit is drawing more blood t... Read more
Reimbursement:
Mitigate OASIS Matching Edit Losses With These 5 Steps
It’s worth it to check HICNs before claim submission. Many home health agencies are... Read more
Appeals:
Know Which OASIS Matching Edit Denials Are Appealable — And Which Aren't
Even appealable denials trigger a full medical review. A simple technical glitch can cost... Read more
Education:
Bone Up On OASIS Matching Edit Facts, Advice
What does your MAC have to say about the reimbursement-robbing edits? You may have though... Read more
Fraud & Abuse:
Update Your OIG Work Plan Schedule
Hospice survey deficiencies are the newest item under the feds’ microscope. Every g... Read more
Industry Note:
Chain Settles Shareholder Suit For $43.75 Million
Insurance covers $15 million. Three years after coughing up $150 million to settle Medica... Read more
Industry Note:
Tune In For New Appeals Procedure Info
Will Medicare’s new claims appeal procedures hurt or help you? You can get more info... Read more
Industry Note:
Start Calculating Your 2017 Hospice Cap Liability Soon
The end of the hospice year is fast approaching — don’t get caught flat footed... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade’s worth of information on a multitude of home health top... Read more
Industry Note:
Share This CCM Tool
Want to help your referral sources understand how to get paid for services they are furnis... Read more
Industry Note:
FISS DDE Screen Changes
Don’t let that new privacy and security message on your FISS DDE welcome screen thro... Read more
Industry Note:
Check Out State Spending
Interested in seeing where your state’s spending is trending? You can check out a ne... Read more
Industry Note:
Make Quality Data — Not Survey Results — Public
If you don’t like the idea of your accreditation survey results going public, you ar... Read more
Industry Note:
LTC Co. Settles Hospice Fraud Charges
Long-term care company Genesis Healthcare Inc. has agreed to pay $53.6 million to settle s... Read more
Industry Note:
HHA Exec Heads To Prison
A California home health agency executive has been sentenced to 18 years in prison for emp... Read more
Industry Note:
Texas Co. Buys Hospice
In Houston, Traditions Health Care Holding Company has acquired Hallmark Hospice through i... Read more
Industry Note:
AARP Rates States
Which states are the best for home care users? The AARP has weighed in on the topic. Long... Read more
Medical Review:
Implement These 6 Ideas To Fight Therapy Denials
Who is reviewing your therapy documentation? One Medicare Administrative Contractor has r... Read more
Therapy:
Wrangle Your Outside Therapist Problem With Careful Contracts
But make sure you’re obeying labor laws. Setting expectations with contract therapi... Read more
HIPAA:
Don't Risk Fines By Overlooking HIPAA BAA Agreements
Warning: Your agency’s small size won’t save you from HIPAA penalties. If you... Read more
Audits:
Plan Ahead To Master A RAC Audit
Tip: Keep abreast of MAC and federal changes to avoid confusion. If you wait until a RAC ... Read more
Hospice:
Your Duty To Adjust Incorrectly Paid Hospice Claims Depends On Your Tracking
CMS doesn’t rule out roster billing. You may want to hold off on adjusting your inc... Read more
Industry Note:
Get Serious About Emergency Preparedness Readiness
Interpretive guidelines are out. If you’ve been waiting (against CMS’s advice... Read more
Industry Note:
Post-Acute Care PPS Moves Forward, Despite Home Care Industry's Misgivings
A prospective payment system cutting across all post-acute providers has drawn major ... Read more
Industry Note:
Fix For Payment System Glitch Scheduled For July
If you thought your claims suspensions with reason code E94G2 were an error, think again. ... Read more
Industry Note:
Use This New CMS Tip To Answer HIS Item A1400 On Payors Accurately
Not sure how to answer A1400 (Payor Information) in the Hospice Item Set? You’re not... Read more
Industry Note:
HHA Owner Draws 17-Year Sentence In Dr. Jacques Roy Fraud Case
One of the HHA owners in the infamous fraud case centering on Dr. Jacques Roy has received... Read more
Therapy:
Follow 8 Documentation Tips To Ward Off Therapy Denials
Denials from Palmetto just keep on coming. One HHH Medicare Administrative Contractor has... Read more
Medical Review:
Your Therapists Should Know These 11 Items Like The Back Of Their Hands
Is your therapy documentation missing any of these elements? HHH Medicare Administrative ... Read more
Hospice:
Weigh Carefully Decision To Reprocess Hospice Claims
The fault is CMS’s, but the work is yours. Will the work of correcting claims paid ... Read more
Fraud & Abuse:
OIG Hammers Home Health Fraud In Semiannual Report
Report revisits $3.1 million hospice settlement. Home health agencies are front and cente... Read more
Industry Note:
Bill Would Reform, Not Replace, Face-To-Face
HHA record would count, too. If you’re looking for relief from the burdensome face-... Read more
Industry Note:
Prevent 38157 Rejections With Some Education
Stop clogging up the Medicare claims payment system with duplicate RAPs, one HHH Medicare ... Read more
Industry Note:
Review Hospice Compare Preview Before It's Too Late
You’ve got until June 30 to review your Hospice Compare preview report and request r... Read more
Industry Note:
Medicare Advantage Plans Scrimp On Care, GAO Says
Home care providers have long contended that Medicare Advantage plans aren’t approvi... Read more
Industry Note:
MCCM Nowhere Near Target Participation Number
The changes the Centers for Medicare & Medicaid Services has made to the hospice concu... Read more
Industry Note:
Medicare Shows Its Zeal For Bundling Programs
Home care providers may have heaved a sigh of relief at the three-month delay to the Compr... Read more
Industry Note:
Prepare Now For Beneficiaries' SSN-Free Medicare Cards
The April 2018 start date for use of Medicare cards with no Social Security Numbers o... Read more
Industry Note:
CMS Proposes Extension For HQRP Exception Deadline
The hospice payment proposed rule for 2018 includes new duties and burdens for hospices (s... Read more
Therapy:
Therapy Denials Rain Down On HHAs
Thousands of claims reviewed in past months. While you may think any amount of medical re... Read more
Medical Review:
Don't Let These Therapy Denial Reasons Torpedo Your Claims
Missing goals, measurements a common claim-killer. Palmetto GBA and the other HHH MACs ha... Read more
Fraud & Abuse:
OIG Report Points To Misguided Fraud Policy For HHAs
Regulatory requirements aren’t catching the real criminals, attorney argues. Since ... Read more
Hospice:
OIG Circles Back To Hospice Fraud Hot Spots
Start your self-audits before you see penalties. Hospices should learn a lesson from home... Read more
Industry Note:
Joint Bundling Program Postponed
Jan. 1 new target date. Home care providers have some extra months before they’ll s... Read more
Industry Note:
Medicaid Whacked In Trump Budget Proposal
There may not be any direct Medicare cuts to home health and hospice services in the Trump... Read more
Industry Note:
Claims Glitch Recovery Process Depends On MAC
The NPI crosswalk glitch that was causing some agencies to have all their claims returned ... Read more
Industry Note:
Check Your Revalidation Date Under New Schedule
Medicare has resumed its “regular revalidation cycles” after its campaign to h... Read more
Industry Note:
Study: Patients Who Refuse HH Rehospitalized More
If you want to encourage referrals from hospital sources, you can use a new study to do so... Read more
Industry Note:
Texas Hospice, Physician Owner Raided By FBI
FBI agents and Texas State Troopers raided the Houston and Beaumont offices of Harbor Hosp... Read more
Industry Note:
Mother And Son Sentenced To 10, 7 Years For Fraud
A mother and son in Ohio have been sentenced to 10 and seven years, respectively, for thei... Read more
Industry Note:
State's Hidden Cameras Catch Patient Abuse By HH Aides
A popular New Jersey program providing hidden cameras to observe home health aides could s... Read more
Industry Note:
Warn Your Patients: OIG Phone Scams Continue
Tell your patients to be wary of callers offering them prizes or cash for personal informa... Read more
Reimbursement:
Beware This CHOW Billing Change
You’ll need a good relationship with the seller or buyer under a new restriction. I... Read more
Hospice:
Know Your Facts: Medicare Now Monitoring Lifetime LOS
Some of the stats CMS cites in the 2018 proposed payment rule may surprise you. Medicare ... Read more
Human Resources:
Don't Make These Mistakes With Your Millennial Employees
You need to figure out the new workforce generation. The percentage of your workers that ... Read more
HIPAA:
Pinpoint Your HIPAA Weaknesses — Before Violations Result In A Breach
Small providers don't get any HIPAA favors. Chances are increasing that if you have I... Read more
Industry Note:
System Glitch Hangs Up All Claims For Some Agencies
Watch our for 32103 claims suspensions. Cash flow has come to a halt for some providers, ... Read more
Industry Note:
Know Which Therapy Modifier To Report For Your NPWT Claims
If you’re confused about the new NPWT billing rules, a new educational tool from a H... Read more
Industry Note:
Give Medicare An Earful About Risk Adjustment
Have an opinion on whether CMS should use social risk factors to adjust its hospice qualit... Read more
Industry Note:
Benchmark Your Non-Cancer LOS Stats With Free Report
Check out whether your length of stay numbers are making you stick out like a sore thumb t... Read more
Industry Note:
PEPPER Helps HHA Curb Red Flag Utilization
If your home health agency has a high number of episodes compared to your peers, do you kn... Read more
Industry Note:
Regional Chain Makes Washington State Buy
The Ensign Group Inc., through its home health Cornerstone Healthcare Inc. unit, is enteri... Read more
Industry Note:
New Jersey Health Systems Merge Agencies
Hackensack Meridian Health and St. Joseph’s Healthcare System in New Jersey are comb... Read more
Industry Note:
4 Physicians Convicted In New Orleans HH Fraud Case
A month-long trial has resulted in six guilty convictions related to the fraud case agains... Read more
Reader Question:
Make Sure You Document Your HIQH Search For Transfers
Are you reporting the right point of origin code? Question: What steps do I need to follo... Read more
Regulations:
HHAs Left Wondering About PCR, CoPs Status
Plus: There’s no time like the present to start reporting CAHPS data. Big changes a... Read more
Payment:
Keep Your Eye On PAC PPS Progress As CMS Mulls Impact Act Data Elements
IMPACT Act bones for MedPAC-endorsed PAC PPS in the works. You have until June 26 to give... Read more
Hospice:
Stay Tuned For Hospice RHC Correction Instructions
Plus: MCCM increases participation after loosening eligibility criteria. Reimbursement pr... Read more
Human Resources:
Prioritize EQ When Making Hiring Decisions
Here’s how to identify high EQs. If you are looking to improve patient engagement a... Read more
Human Resources:
Use Interview Questions To Find High EQ Staffers
The past will help indicate the future. Deciding to make emotional intelligence important... Read more
Fraud & Abuse:
Texas Fraud Convictions, Guilty Pleas Rack Up
Kickbacks draw investigators’ attention. An attempt to evade fraud detection worked... Read more
Industry Note:
Copays May Not Solve Budget Problems, Study Suggests
Copays don’t curb utilization. When law- and policymakers go looking for places to ... Read more
Industry Note:
CoP Compliance Hinging On LEP Patients Could Be A Challenge, New Study Indicates
How much work will it be to get into compliance with the new requirements for Limited Engl... Read more
Industry Note:
Hospitals Hang Out The Home Health, Hospice 'For Sale' Signs As Profit Margins Dwindle
Two more hospitals are shedding their home care units. Island Hospital in Annacortes, Wash... Read more
Industry Note:
New Orleans Physician Pleads Guilty In Kickback Case
Physician Jobie Crear, operator of Comprehensive Nursing and Home Health Service Inc. in N... Read more
Industry Note:
Feds Continue Crack-Down On Medicaid Home Care Fraud
Medicaid fraud continues to be on the fraud enforcement radar. In Pittsburgh, federal and ... Read more
Industry Note:
Learn More About B-12, Insulin Injection Coverage Requirements From MAC
With medical review on the rise, now’s a good time to brush up on coverage requireme... Read more
Hospice:
Medicare Pay Increase Drops To 1% For 2018
Warnings: Rebasing cuts seem poised on the horizon. As your costs rise, your reimbursemen... Read more
Reimbursement:
Expect Rebalancing At Best, Rebasing Cuts At Worst, Proposed Rule Suggests
Hospices overpaid for RHC, cost report analysis indicates. A year of a reduced payment up... Read more
Documentation:
Physician Documentation Requirement Could Cause Hospice Access Problems
Your payment could depend on the referring physician’s medical record. Compared to ... Read more
Hospice:
Watch Out For Part D Payment Concerns
Forthcoming assessment tool gets a name. You may soon find yourself on the hook for your ... Read more
Quality:
Hospice Compare Line-Up Is Set
Plus: 5-star ratings will hit the public reporting site sooner rather than later. The Cen... Read more
HIPAA:
Give Your HIPAA Plan A Check-Up
Who’s your security officer? If the flip phone was the mainstay the last time you d... Read more
Industry Note:
Don't Let RAP Time-Outs Affect Your Cash Flow
You also need to be sure these fields match. Almost one-quarter of claim submission error... Read more
Industry Note:
Access These Quality Reports Via CASPER
You can now access your Home Health Quality Reporting Review and Correct reports in the CA... Read more
Industry Note:
Get To Know New Advocacy Organization
The Visiting Nurse Associations of America has launched a new non-profit advocacy organiza... Read more
Industry Note:
Publicly-Traded Chain To Form New Joint Venture
LHC Group Inc. and Memphis-based Baptist Memorial Health Care have agreed to form a new jo... Read more
Industry Note:
Bayada Makes Deals With Hospitals
Bayhealth health system in Delaware and New Jersey-based Bayada Home Health Care are formi... Read more
Pre-Claim Review:
Good News/Bad News: PCR Is Off, But Probe & Educate Is On
P&E round about three-fourths over, MAC reveals. A silver lining for home health agen... Read more
Pre-Claim Review:
Will Home Health Probe & Educate Denial Rates Change?
HHAs have a chance to show their face-to-face documentation has improved. A Palmetto GBA ... Read more
Conditions of Participation:
Cover Your Language Bases Under New Patient Rights CoP
Crucial: Know what ‘understandable’ means. Home health agencies have their ha... Read more
Compliance:
Know Your CoP Interpreter Obligations
Professional interpreters should be first choice. Just how far do you need to go to make ... Read more
Patient Rights:
Here's The Language On Your Language Responsibilities Under New CoPs
You have 2 visits to get an interpreter involved after furnishing a written notice in the ... Read more
Industry Note:
MACs Should School Docs On HH Documentation, GAO Says
HHAs powerless to affect docs’ documentation, feds admit. For once, home health age... Read more
Industry Note:
Plan Your Emergency Prep Testing Before It's Too Late
You have until Nov. 15 to meet the requirements of Medicare’s Emergency Preparedness... Read more
Industry Note:
Master NOE Correction Procedures To Minimize Loss
You’ve got a new tool to help you curb Notice of Election-related losses. The probl... Read more
Industry Note:
Direct Your ABN, CCN Questions Here
Do you have questions about your Beneficiary Notice Initiative notices, particularly in ad... Read more
Industry Note:
CMS Wants Accrediting Bodies To Make Survey Results Public
Getting your Medicare certification through an accrediting organization (AO) may no longer... Read more
Industry Note:
Kindred Takeover Speculation Fuels Stock Price Increase
About two-and-a-half years after Kindred Healthcare Inc. took over Gentiva, the Louisville... Read more
Industry Note:
California Hospice, VNA Merge
Camarillo Hospice and Livingston Memorial Visiting Nurse Association and Hospice in Ventur... Read more
Conditions of Participation:
Top Your CoP Priority List With Patient Rights Notices
What should you cover in the verbal review? You have six additional months to get into co... Read more
Regulations:
Read Up On Your New Patient Rights Notice Responsibilities
Heed the new timelines. You’ll be responsible for the new Patient Rights Condition ... Read more
Compliance:
Take These 8 Steps To Gear Up For New Patient Rights CoP
Use this advice to minimize the impact of the new requirements. Feeling overwhelmed by on... Read more
Patient Rights:
Get To Know Your Other Patient Rights Requirements
5 of the 12 patients’ rights items involve notices. Just what are your patients&rsq... Read more
Conditions of Participation:
Don't Forget: You Must Issue This Info To Patients, Too
You’ll hand out clinical manager contact details. The new Patient Rights Condition ... Read more
Industry Note:
Match Your UTNs Correctly Or Risk Additional Medical Review
Request a reopening to attach UTN. Yes, Medicare wants Illinois home health agencies to s... Read more
Industry Note:
BearWith MAC As It Manually Works Around E94G2 Claims Processing Glitch
Try to hold your horses when it comes to claims stalled with reason code E94G2 in status/l... Read more
Industry Note:
Tune In To Medicare Education Call About Hospice Compare Preview Reports
Get ready to hit the ground running for Hospice Compare with a free webinar from the Cente... Read more
Industry Note:
Share Your Thoughts On Your MAC's Job Performance With CMS
You have an opportunity to give CMS feedback on how your HHH Medicare Administrative Contr... Read more
Industry Note:
Chain Enters Mississippi With Acquisition
AccentCare Inc. has acquired Mississippi’s largest home health provider, Jackson-bas... Read more
Industry Note:
Download Your Latest Hospice PEPPER Stats
Hospice’s latest PEPPER reports, which include data from the fourth quarter of fisca... Read more
Pre-Claim Review:
Pre-Claim Review Pauses For Serious Revamp
P-A-U-S-E spells relief. At long last, home health agencies are seeing the assistance the... Read more
Medical Review:
How Voluntary Will A Voluntary PCR Program Really Be?
Avoid putting a target on your back, industry rep warns. Choosing whether to participate ... Read more
Pre-Claim Review:
Keep Putting Your UTNs On Claims, Q&A Says
Otherwise claims will process as normal. Home health agencies left with questions after t... Read more
Conditions of Participation:
HHAs Get 6-Month Breather on HH CoPs
Watch out for transition period mistakes. The implementation date for the new and revised... Read more
Compliance:
Keep Current Conditions Of Participation In Mind
Navigate tricky transition period or face penalties. In addition to just planning for Hom... Read more
Surveys & Certification:
Doubled CMP Amounts Make Your Timely CoP Compliance Critical
Survey citations can shut your doors in a heartbeat. Whether it’s compliance with t... Read more
Industry Note:
Head Off PECOS Edit Denials With These 3 Steps
Don’t forget to check the doc’s specialty code. If you’re accessing onl... Read more
Industry Note:
MAC Launches Hospice RHC Probe In All Settings
One MAC is turning up the heat on hospice claims. HHH Medicare Administrative Contractor ... Read more
Industry Note:
NGS Shares Notice Of Election Education Tool
Election notices are a hot topic for scrutiny, and hospices served by HHH Medicare Adminis... Read more
Industry Note:
Note This New Form For Kickback Self-Disclosures
Medicare has issued a new form you need to use starting June 1 in physician kickback viola... Read more
Industry Note:
Learn About Your Recovery Audit Contractor
Get some insight into what your new home care and hospice-specific Recovery Audit Contract... Read more
Industry Note:
LHC, West Virginia Hospital Partner
LHC Group Inc. has entered into a home health and hospice joint venture with Pleasant Vall... Read more
Industry Note:
Florida Opening Marks VITAS' 45th Location
VITAS Healthcare’s new office in Pensacola, Fla., is its forty-fifth location, the P... Read more
OASIS:
Check These 4 Items To Avoid OASIS Edit Denials
Make sure your clinicians know the difference between M0030 and M0090. If you don’t... Read more
Regulations:
Star Rating Calculations Stay The Same Through Summer
Plus: Grab your last chance for free training. Medicare is taking a bit more time than it... Read more
Reimbursement:
Don't Expect Medicare To Fix Your SIA Underpayments
Hospice pay reform billing headache drags on. The news that you’ll likely have to a... Read more
Compliance:
Know The New OIG Exclusion Details
Feds can reach back 10 years for exclusion grounds. Now is the time to make sure you&rsqu... Read more
Audits:
Respond To Audits With These 7 Steps
Have your site visit response plan ready to go. Audits are a fact of life under Medicare,... Read more
Hospice:
7 New HIS Items Go Live April 1
Hospice Item Set additions are no joke. How accurately you fill out the new Hospice Item ... Read more
Industry Note:
NQF Recommends Dumping 11 Stabilization Quality Measures
Measures have topped out, advisory body judges. You may have fewer home health quality me... Read more
Industry Note:
SMRC Launches Audits Of Hospice General Inpatient Stay Claims
You may get even more scrutiny of your hospice claims, thanks to a Supplemental Medical Re... Read more
Industry Note:
Make This Tweak To Your Home Health Advance Beneficiary Notice Form
You need to put a new expiration date on your Advance Beneficiary Notice forms. ABN Form C... Read more
Industry Note:
Warning: Mixing Up Your Hospice And Home Health G Codes For Nursing Will Lead To Claims Returns
Don’t let common G code confusion slow your cash flow. The problem: HHH Medicare Ad... Read more
Industry Note:
Trial Over HHA Federal Fraud Charges Limps To A Close In Chicago
A high profile home care fraud case in the Chicago area has imploded due to prosecutorial ... Read more
Budget:
MedPAC Pushes For 5% HHA Pay Cut
Profit margin fluctuation may give you whiplash. With all the political changes sweeping ... Read more
Know Your Facts:
Number Of Home Health Episodes Rise After 3-Year Decline
Profit margin jumps 44% in single year. Indicators including the number of home health ag... Read more
Therapy:
MedPAC Goes Beyond The Cut
Advisory body hammers therapy problems. The Medicare Payment Advisory Commission doesn&rs... Read more
Hospice:
MedPAC Concerned About For-Profits, Long-Stay Patients
Advisory body recommends hospice rates stay flat next year. Medicare profit margin and ho... Read more
Industry Note:
Verma In As CMS Administrator
Medicaid changes top priority list. Home health agencies and hospices wondering if Seema ... Read more
Industry Note:
Trump Wants More Fraud Investigations
President Trump’s budget blueprint does not address Medicare spending exactly, but i... Read more
Industry Note:
Prioritize Cost-Saving Home Care, Reps Urge Congress
Meanwhile, the home care industry is reacting to the Republicans’ American Health Ca... Read more
Industry Note:
Cardiac, Joint Bundling Dates Pushed Back
Home health agencies may not have received much-hoped-for relief from Pre-Claim Review, wh... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade’s worth of information on a multitude of home health top... Read more
Industry Note:
Don't Miss Cap Deadline March 31
Hospices have mere days left to calculate and self-report any annual cap overpayments, wit... Read more
Industry Note:
Tune In To IMPACT Act Call For Field Test Info
A national field test for IMPACT Actrequired quality patient assessment items is on its wa... Read more
Industry Note:
Mark This HQRP Schedule Change In Your Calendar
If you signed up for the Hospice Quality Reporting Program training webinar from CMS on Ap... Read more
Industry Note:
Home Health And Hospice M&A Market Rose In 2016
Merger & acquisition activity in the home health and hospice market increased 12 perce... Read more
Industry Note:
HHA RN Pleads Guilty In Houston Fraud Case
An RN has pleaded guilty to his role in a Houston home care fraud scheme. Charles Esechie... Read more
Pre-Claim Review:
FL Agencies Face PCR Starting April 1 — No Exceptions
Illinois agencies improve affirmation rates. Home health agencies in the next state to ge... Read more
Fraud & Abuse:
Check Out The 3 New Safe Harbors Most Likely To Apply To You
Are you considering offering free transportation to your patients? Medicare’s shift... Read more
OASIS:
Make Sure You're In Compliance With M1060b Guidelines
New Q&As highlight one exemption. Clinicians completing OASIS have had their hands fu... Read more
HIPAA:
Use Authentication To Protect Against HIPAA Violations
Make some new priorities related to cyberattacks and hacking. You may be getting a false ... Read more
Human Resources:
Help Your Employees Deal With Their Baggage
Are your expectations realistic? If you expect your employees to leave their personal iss... Read more
Industry Note:
You Need This Item Before Appealing RAC Denial
Don’t jump the gun. Homecare providers are waiting to see what topics get approved ... Read more
Industry Note:
Re-Run These Hospice Reports
If you’ve run any Hospice-Level Quality Measure Reports or Hospice Patient Stay-Leve... Read more
Industry Note:
Medicaid Fraud Control Units Rack Up Indictments
It’s not just federal authorities who will be scrutinizing you for fraud. State Medi... Read more
Industry Note:
Certifying Physician Must Go On Claim
Are you out of compliance with a Medicare claims requirement to put two physicians on the ... Read more
Industry Note:
Medicare Launches CCM Awareness Campaign
Medicare is making a push to raise awareness of its Chronic Care Management services, and ... Read more
Industry Note:
Physicians Must Document F2F, CMS Stresses
Ahead of Pre-Claim Review’s April 1 launch in Florida, the Centers for Medicare &... Read more
Industry Note:
Hospice-Paramedic Partnerships Reduce ER Visits
Hospices looking for ways to reduce their costs and build better relationships with their ... Read more
Industry Note:
HHA Owner Indicted For $15 Million Fraud Scheme
A Miami home health agency owner has been indicted on Medicare fraud charges, the Departme... Read more
Industry Note:
2 Ohio Agency Owners Convicted Of Medicaid Fraud
Two owners of an Ohio home care agency have been found guilty of Medicaid fraud after a se... Read more
Legislation:
ACA Replacement Bill Could Mean Big Changes For Home Health, Hospice
Legislation’s road to enactment riddled with potholes. Ding dong, the employer ... Read more
Legislation:
Stay Tuned For More Repeal & Replace Specifics
New HHS Secretary Promises More ACA repeal phases. Home care providers’ futures ... Read more
Hospice:
Sentencing In Hospice Fraud Case Casts More Shadows On Industry
Fraudsters lying to families about loved ones’ terminal illnesses a low blow. On... Read more
Fraud & Abuse:
Kickbacks, Physicians Feature In Latest Crop Of Fraud Cases
HEAT cities see more home care fraud. Fraud-fighting activities in home care fraud hot... Read more
Pre-Claim Review:
Clock Ticks Down To Florida PCR Implementation April 1
Which state will be next? Florida home health agencies’ hopes for a Pre-Claim Re... Read more
Studies & Surveys:
Studies Show Cost-Saving Power Of Hospice
Access to financially beneficial care restricted for obese beneficiaries. Hospice serv... Read more
Industry Note:
MAC Offers New F2F Education
Make sure the physician meets the requirements for incorporating your documentation. F... Read more
Industry Note:
Get HHQRP Info Straight From The Horse's Mouth
The Centers for Medicare & Medicaid Services is offering two-day in-person training ... Read more
Industry Note:
New NOE Edit Will Hit This July
If your billing staff is sloppy with the dates of Notices of Election, you’ll star... Read more
Industry Note:
Watch For These Claims Adjustments
Mysterious underpayment corrections may be due to a fix HHH Medicare Administrative Cont... Read more
Industry Note:
Home Care Chain Buys Health System's Agencies
The home health and hospice agencies Tenet Healthcare recently announced it would shed h... Read more
Industry Note:
LTC, Senior Living Facilities Venture Into Home Care
Three long-term care and senior living providers in Western Michigan are joining forces ... Read more
Industry Note:
Don't Pick Up This Phone Call, OIG Warns
Your patients should beware a phone scam from fraudsters pretending to be HHS Office of ... Read more
Reimbursement:
Don't Let Your Software Lull You Into OASIS Matching Edit Complacency
Major money will be on the line when new edit hits April 1. If you think the upcoming ... Read more
OASIS:
Take These 8 Steps To Head Off OASIS Edit Losses
Silver bullet: Check Final Validation Reports. There are many scenarios in which an OA... Read more
Compliance:
OASIS Matching Edit Culmination Of Years Of Scrutiny
OASIS submission a new must. Why are your OASIS submissions so important to Medicare &... Read more
Fraud & Abuse:
High-Profile Hospice Fraud Case Hits All The Hot Spots
Tip: If you’re going to commit fraud, don’t text about it. Your job may ha... Read more
Kickbacks:
Hospice Medical Directors Under The Fraud Microscope
Physicians must call the shots, case stresses. Get ready to defend your hospice medica... Read more
Industry Note:
Avoid G Code Confusion Or Risk Returned Claims
Use this MAC’s handy G code chart. To get your skilled nursing coding right, you... Read more
Industry Note:
GAO: HHS Should Nail Down Specifics Of Plan To Increase EHRs In Post-Acute Care
The day that Medicare will require electronic records or apply a penalty for home health... Read more
Industry Note:
Home Health & Hospice RAC Gears Up
Expect Recovery Audit Contractor scrutiny to resume soon. The new RAC dedicated to home ... Read more
Industry Note:
SIA Adjustments Cause More Billing Headaches
If you tried to secure a claims adjustment for a Service Intensity Add-on error and... Read more
Industry Note:
NPWT Billing Changes Issued In New Transmittal
Medicare has given MACs their marching orders about new NPWT billing rules. Recap... Read more
Industry Note:
PEPPER Training On Deck
Get more details about your new hospice PEPPER report in an April 25 webinar by PEPPER c... Read more
Industry Note:
Beware HICN Glitch In ELGA/ELGH
You may not be getting your patient’s correct HICN if you use ELGA and ELGH, ... Read more
Hospice:
Hospices Hope For Resolution To Endless Cap Recalculations
Dilemma: Pay up or hold off? Hospices that have received cap overpayment demands for c... Read more
Medical Review:
Defend Observation & Assessment Visits With These MAC Documentation Tips
Do meds you list as new or changed fit within this MAC’s time frame? Will sloppy... Read more
Fraud & Abuse:
Ohio HHA Owner, Manager Convicted For Fraud
Plus: Physician indicted for home care kickback solicitation. Pinning Medicare, Medica... Read more
Compliance:
Use Your PEPPER Report — Before The Feds Do
HHAs lag in using government-supplied benchmarks. If you think diving into your free P... Read more
Benchmarks:
Follow These Agencies' PEPPER Examples
Some ways you can use these free benchmarking reports may surprise you — including... Read more
Industry Note:
Verma On Track For CMS Administrator Spot
Would nominee favor a home health copay? President Trump’s nominee for Administr... Read more
Industry Note:
Medicare Utilization To Trend Up, Actuary Forecasts
Projections for Medicare spending are going up, and that means you should prepare for yo... Read more
Industry Note:
Florida HHAs Can Get PCR Answers In Feb. 28 Call
Florida agencies that bill CGS can get PCR info in a Feb. 28 Ask-the-Contractor Teleconf... Read more
Industry Note:
MAC: Wait Patiently For Billing Glitch Resolution
CGS wants providers to pipe down about claims/adjustments suspending with reason codes E... Read more
Industry Note:
PCR Request Must Come Before Final Claim, Q&A Says
Watch out for this deadline no-no under the Pre-Claim Review demonstration project. Flor... Read more
Industry Note:
Medicare Updates Home Health Benefit Booklet
Medicare has updated its educational booklet about the home health benefit. The booklet ... Read more
Make The Most Of Your Eli's Home Care Week Subscription
You have more than a decade’s worth of information on a multitude of home health t... Read more
Conditions of Participation:
HHAs Anxiously Await CoPs' Interpretive Guidelines
Could a delay be on the horizon? Along with the crushing everyday burdens home health ... Read more
Reimbursement:
Get Ready For OASIS Edit To Hurt Your Bottom Line
But there are 6 reasons the new edit may not be as bad as you think. If you miss your ... Read more
Regulations:
Disregard New Therapy CPT® Codes, Unless You Bill Part B
Plus: CMS didn’t address Pre-Claim Review in latest forum, but MAC offers resources.... Read more
Demonstration Projects:
CMS Highlights More Care Choices Model Changes To Increase Participation
MCCM phase 2 training coming up, CMS promised. Hospices chosen to take part in Medicar... Read more
Hospice:
Pay Reform Continues To Give Hospices Billing Nightmares
Plus: Use these free HQRP training resources. Snafus related to billing hospice Routin... Read more
Regulations:
Price Confirmed HHS Secretary
Industry hopes for PCR changes within 6 weeks. With Tom Price confirmed as Health and ... Read more
Lawsuits:
CMS To Spread The Word On Improvement Standard Ban
Medicare didn’t live up to its responsibilities, federal judge says. Although th... Read more
Lawsuits:
Medicare Will Issue This Jimmo Statement
Here’s the language Vermont federal court is requiring Medicare to issue: &ldquo... Read more
Industry Note:
Avoid This Vaccination Billing Mistake
You may need to adjust your claims. A coding mix-up could be subjecting you and your p... Read more
Industry Note:
Get CCM, IMPACT Act Info From New Educational Calls
You or your referral sources might want to tune in to forthcoming educational calls CMS ... Read more
Industry Note:
Turn To MAC Resource For Hospice Cap Assist
Need a little help getting your hospice cap information calculated and reported by the M... Read more
Conditions of Participation:
Make Sure Your Governing Body Is Up To Tasks Required By CoPs
QAPI will make some unfamiliar demands. As you go about implementing the many new requ... Read more
Regulations:
Follow 4 Pointers For Governing Body QAPI Compliance
Get started on education efforts right away. The July 13 deadline for the new Conditio... Read more
Conditions of Participation:
Examine Your Governing Body's New Responsibilities
The new CoPs will add a lot more to the plate. New governing body duties are sprinkled... Read more
Compliance:
Governing Body's New Duties Go Beyond QAPI
Board must approve Administrator backups, new CoPs say. Under the incoming Conditions ... Read more
Hospice:
Past Years' Hospice Cap Overpayments A Moving Target
Beware reopenings — and repayments — long after the fact. If you have a nu... Read more
Reimbursement:
Use These 5 Steps To Cope With Cap-Based Reopenings
Tip: The PS&R report may not be enough. Medicare contractors’ recalculations... Read more
Industry Note:
Prepare For ED Use To Influence Your Star Rating
Will you be one of the 16 percent of agencies with lower ratings? You may not like the... Read more
Industry Note:
MAC Denies 1 Out Of 10 CH** Claims In Probe
You’d better make sure your documentation for patients with the highest clinical a... Read more
Industry Note:
Stay On Top Of Hospice Cap Reporting Changes
You might be worried about previous years’ cap-related overpayments (see story, p.... Read more
Industry Note:
Beware HIC Glitch
If you’re trying to look up beneficiary information in the Common Working File and... Read more
Industry Note:
Medicare To Consolidate DME Bidding Rounds
Medicare’s competitive bidding process for DME may get a bit easier to track soon.... Read more
Industry Note:
Home-Based Primary Care Saves Money, Project Shows
The second performance year of the Independence at Home Demonstration, which provides ch... Read more
Industry Note:
Heed 2 LSC Survey Memos
Hospices with inpatient facilities can’t afford to overlook two new Survey & C... Read more
Industry Note:
Tenet To Shed Home Care
Dallas-based health system Tenet Healthcare Corp. plans to sell its home care and hospic... Read more
Conditions of Participation:
Put Discharge/Transfer Summary At The Top Of Your CoP To-Do List
Can you meet the 2-day deadline for transfer summaries? If you have the best discharge... Read more
Regulations:
Get Friendly With Your New Discharge/Transfer Summary CoP
Gear up for the 5- and 2-day deadlines, respectively. You will be responsible for this... Read more
Conditions of Participation:
Summary Content Is Up To You — For Now
Stay tuned for separate rule on discharge/transfer summary content. Not sure what shou... Read more
Documentation:
22 Items Proposed For Discharge/Transfer Summaries
To get an idea of what may be on your plate, take a look at the proposed 22 items requir... Read more
Strategy:
Heed These 8 Pointers For Discharge/Transfer Summaries
Here’s how the summaries requirement and QAPI overlap. July 13 is rushing toward... Read more
Reimbursement:
MedPAC Finalizes Rec To Cut HHA Rates 5%
Advisory body revises upward profit margin projection for 2017. It may not be a surpri... Read more
Hospice:
MedPAC Recommends Another Hospice Rate Freeze
Hospice provider numbers continue to grow. Declining profit margins may not be enough ... Read more
Industry Note:
Executive Order On ACA Burden Unlikely To Help Home Care
Watch for a legislative opportunity. Home health agencies hoping for a quick fix to th... Read more
Industry Note:
MACs Offer 2 New Pre-Claim Review Tools
The HHH Medicare Administrative Contractors are offering two more Pre-Claim Review tools... Read more
Industry Note:
Nursing G Code Glitch Returns Claims In Error
A Medicare payment system glitch related to the four new nursing G codes that took effec... Read more
Industry Note:
Hospice Compare Date Slides To Late Summer
You’re getting a smidge of breathing room on Hospice Compare, as the Centers for M... Read more
Industry Note:
UPICs Take Over From ZPICs, PSCs, And MICs
You may have a new set of reviewers looking over your shoulder. CMS has awarded the Nort... Read more
Conditions of Participation:
Take These 7 Steps To Start Mastering The New CoPs
There’s no time to waste. If you don’t get up to speed on the newly final... Read more
Regulations:
Read Your New Transfer And Discharge CoP Standard
You must take these 4 steps when discharging for staff safety reasons. The Centers for... Read more
Conditions of Participation:
Care Termination CoPs Hold Some Disappointments
Not meeting F2F requirements should be ‘exceptionally rare,’ CMS says in CoP... Read more
Compliance:
Gear Up To Distribute Your Discharge Policy To Patients
The surveyor will be checking. Don’t forget, it’s not enough to formulate ... Read more
Regulations:
CMS Shoots Down Extra Discharge-Related Burdens
Warning: Surveyors will be reviewing your cases discharged for cause. While home healt... Read more
Face-To-Face:
Troubleshoot These Common F2F Mistakes
Tip: Documentation must include physician’s actual visit note. If you want your ... Read more
Industry Note:
Claims Processing Glitch Delays Reimbursement
Is V8030 on your radar? If you’ve got claims suspended in a newly identified err... Read more
Industry Note:
Along With The New Year Comes A New Form I-9
• Make sure you’re using this updated employment form or risk fines. &ldquo... Read more
Industry Note:
Alert Your Referring Docs To 2017 CCM Changes
• If your physician referral sources bill for Chronic Care Management, you might wa... Read more
Industry Note:
VNA Settles Fraud Charges For $5.25 Million
• A Connecticut VNA and its husbandand-wife owners have ponied up $5.25 millio... Read more
Industry Note:
Another Guilty Plea In Houston Home Health Case
• The administrator of five Houston-area home health agencies has pled guilty to $7... Read more
Industry Note:
HIPAA Audit Phishing Scam Preys On Providers
• Don’t let your zeal for HIPAA compliance put you at risk. A cybersecurity f... Read more
Conditions of Participation:
Ready, Set, Go On Compliance With Long-Awaited New COPs
Time is of the essence. A regulation change 20 years in the making is final at long la... Read more
Compliance:
Know This Timeline Exception
Medicare will give you some breathing room for quality improvement. Medicare did relen... Read more
Regulations:
Peruse The Many Changes In The New COPs
Prepare for care transition focus. The long-awaited final rule on Home Health Conditio... Read more
Conditions of Participation:
Patient Rights, Discharge Summary Top CoP Challenges
Are HIPAA-based survey citations on deck? Between reimbursement cuts, Pre-Claim Review... Read more
Select Conditions of Participation Revisions
Revised §484.50(a)(1) to clarify that it is the patient’s legal representa... Read more
Survey & Certification:
HHAs Welcome These Changes
Verbal order clarification a boost. You don’t have to worry about one troubling ... Read more
Face-To-Face:
HHAs Look To Improve On 60% Denial Rate In Probe & Educate
F2F problems dog P&E claims. As Medicare kicks Round 2 of the Probe & Educate ... Read more
Industry Note:
HHA Moratoria Continues
No end in sight. It’s at least six more months of no new home health agencies in... Read more
Industry Note:
Medicare Prepares 2 New Quality Measures On 'Transfer of Health Information and Care Preferences'
You can get a sneak peak at two more IMPACT Act-required quality measures if you partici... Read more
Quality:
HHAs On Hook For Physician Response Again — This Time For Medication Issues
CMS rebuffs pleas for change. As you are rolling out OASIS-C2 in your home health age... Read more
Regulations:
Lookback Period Burdens HHAs Under New Medication Measure
Measure’s facility bias also a concern. Home health agencies are very concerned ... Read more
Policies & Procedures:
Nail Down 'Clinically Significant' Definition For New Medication Review Measure
Make sure M2001-M2005 don’t trip up your quality scores — or compliance. Y... Read more
Hospice:
Prepare For Year Of Hospice Quality
Add these tools to your quality improvement kit. Medicare is turning up the heat on it... Read more
Quality:
7 Quality Measures
Scan the list that ranges from bowels to beliefs. For one of your new hospice quality ... Read more
Industry Note:
New Year, New Rates
Zero in on your claim’s ‘through’ date to pin down your correct reimbu... Read more
Industry Note:
Internal Revenue Service Mileage Rate Ticks Down A Dab This Year
If you base your travel reimbursement to employees on the IRS’s standard mileage r... Read more
Industry Note:
New York Home Care Provider Slapped With $25K HIPAA Fine Over Marketing – Are You Next?
HIPAA penalties don’t just come from the federal government. For example: New Yo... Read more
Industry Note:
Michigan-Based Regional Hospice Chains Makes Buys In Ohio, Kansas
Jackson, Mich.-based Great Lakes Caring Home Health and Hospice has purchased Grace Hosp... Read more
Industry Note:
For-Profit Chain Finalizes Joint Venture That Will Operate 20 Home Health Agencies, 10 Hospice Locations
LHC Group Inc. and Brentwood, Tenn. based LifePoint Health have finalized the formation ... Read more
Pre-Claim Review:
Pre-Claim Review To Launch In Florida April 1
Administrative burden is program’s biggest fault. It’s no joke: The much-r... Read more
Pre-Claim Review:
HHAs Stare Down PCR Program Riddled With Problems
The demonstration has made some improvements, however. The potentially unsustainable w... Read more
Medical Review:
Hey, Remaining 3 Demo States: Don't Delay In PCR Prep
Meanwhile, industry pursues PCR eradication. The home health industry continues to try... Read more
Strategy:
Follow These 6 Hard-Learned Tips For PCR Preparation
Use MAC’s vital Pre-Claim Review checklist. Home health agencies in Florida shou... Read more
Face-To-Face:
Get Ready For Round 2 Of F2F Probe & Educate
Will denial rate north of 90% persist? Medicare gave Florida home health agencies yet ... Read more
Fraud & Abuse:
Don't Let Internal Audits Cost You Millions
Ignore a hospice patient who has been on service for 5 years at your own peril. If you... Read more
Fraud & Abuse:
Guilty Pleas Rack Up In Home Care Fraud Case
2 home visit physicians called on the carpet. If more than 97 percent of a physician p... Read more
Industry Note:
Beware One MAC's New Signature Deadline
MAC rescinds hasty policy interpretation. Put one more time point on your list of dead... Read more
Industry Note:
CMS To Hold HHGM Call
Want to find out more about Medicare’s plans for drastic home health payment refor... Read more
Industry Note:
HHA PUF Data Updated
See how you measure up against Medicare’s latest data released for home health age... Read more
Industry Note:
Open Door Forum Bumped
Scratch Medicare’s Jan. 11 Home Health, Hospice and DME Open Door Forum off your c... Read more
Industry Note:
Keep Tabs On These January CAHPS Dates
You can access your Preview Report for Home Health CAHPS data on Jan. 6, the Centers for... Read more
Industry Note:
Prior Authorization Goes Nationwide This Summer
Your patients who need two types of power wheelchairs, K0856 and K0861, may have a longe... Read more
Industry Note:
HHA Fraudsters Funnel Patient Kickbacks Through Charity
Mother and son Martha and Luis Lima have pled guilty to Medicare charges, the Miami Hera... Read more